Effects of Capnometry Monitoring in Post Anesthesia Care Unit

Not Applicable

Completed

• Conditions: VENTILATION; Capnography
• Interventions: Device: CAPNOGRAPHY

• Registration Number: NCT03370081
• Lead Sponsor: University Hospital, Bordeaux

Brief Summary

There is few information about the best capnometry value in recovery room for intubated awakening patients. Furthermore, capnometry values could influence ventilation applied by nurses on these patients. The aim of this study is to observe the effects of capnometry monitoring on intubated awakening patients in recovery room.

Detailed Description

In France, there is actually no recommandation about capnography monitoring in recovery rooms. Nevertheless, some patients are still ventilated in post-anesthesia care units during awakening period. Alveolar hypoventilation could induce moderate hypercapnia, thereby stimulate central ventilatory command. However, this hypoventilation could delay the clearance of anesthetic gases. Capnometry monitoring could influence ventilation applied to these patients. Recovery rooms nurses would perform moderate hyperventilation in response to hign capnometry values. This method could enhance gases elimination, with faster spontaneous breathing recovery and extubation. Length of stay in recovery room could also be shortened. An objective surrogate of ventilation is maximal End Tidal CO2, if there is no alveolo-capillary gradient abnormality (Obesity, Chronic respiratory disease, Cyanogenic heart disease). Thus, this study will compare the percentage of patients who reached a maximum End Tidal CO2 greater than 45mmHg during awakening period in post-anesthesia care unit (PACU) in 2 groups :

* first group ("non-blind group") with capnography monitoring see by the PACU nurses

* second group ("blind group") with capnography monitoring but PACU nurses cannot see the values Other parameters like the time between ventilator's disconnection and the first ventilatory cycle in spontaneous ventilation, the time between ventilator's disconnection and tracheal extubation or laryngeal mask's withdrawal, the minimal SpO2 reached after tracheal extubation or laryngeal mask withdrawal or the length of stay in PACU are also recorded.

Study Timeline

• Study First Submitted: 2017-12-04
• Study First Submitted QC: 2017-12-11
• Study First Posted: 2017-12-12
• Study Start: 2018-01-15
• Primary Completion: 2018-05-01
• Study Completion: 2018-06-01
• Status Verified: 2018-10
• Last Update Submitted: 2018-10-14
• Last Update Posted: 2018-10-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 53

Inclusion Criteria

• Major patients with given written consent
• General anesthesia, induction with Propofol infusion and Target-Controlled Infusion (TCI) remifentanil, relayed with inhaled sevoflurane and TCI remifentanil
• Upper airway control with naso-orotracheal tube or laryngeal mask
• Ventilated normotherm patients in PACU

Exclusion Criteria

• Minor or pregnant patients
• Obesity with Body Mass Index > 40 kg/m²
• Chronic respiratory disease with SpO2<90% in ambiant air
• Cyanogenic heart disease
• Patients under myorelaxant in PACU

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
CAPNO+	CAPNOGRAPHY	END TIDAL CO2(EtCO2) is monitoring and PACU nurses can see the values delivered by the capnography device

Primary Outcome Measures

Name	Time	Method
End Tidal CO2 up	through awakening period in PACU, an average of 30 minutes	Percentage of patients who reached a maximum End Tidal CO2 greater than 45mmHg during awakening period in post-anesthesia care unit (PACU)

Secondary Outcome Measures

Name	Time	Method
spontaneous ventilation time	through awakening period in PACU, an average of 15 minutes	Time (in minutes) between ventilator's disconnection and the first ventilatory cycle in spontaneous ventilation
length of stay in PACU	through awakening period in PACU, an average of 2 hours	Length of stay in PACU in minutes
time for removal of airway device	through awakening period in PACU, an average of 30 minutes	Time (in minutes) between ventilator's disconnection and tracheal extubation or laryngeal mask's withdrawal
Spo2 min	through awakening period in PACU, an average of 2 hours	Minimal SpO2 after tracheal extubation or laryngeal mask withdrawal
End Tidal CO2 max 2	through awakening period in PACU, an average of 30 minutes	Maximum EtCO2 reached after the first ventilatory cycle in spontaneous ventilation
End Tidal CO2 max 1	through awakening period in PACU, an average of 15 minutes	Maximum EtCO2 reached before the first ventilatory cycle in spontaneaous ventilation
respiratory rate	through awakening period in PACU, an average of 15 minutes	Respiratory rate applied by PACU nurse before the first ventilatory cycle in spontaneous ventilation
time for oxygenotherapy removal	through awakening period in PACU, an average of 1 hour	Time (in minutes) between tracheal extubation or laryngeal mask withdrawal and oxygenotherapy weaning

Trial Locations

Locations (1)

Centre hospitalier Universitaire de Bordeaux; 🇫🇷 Bordeaux, France